Notes from Dr. Kilbane MD, Pediatrician

Is Your Young Child Creative With The Truth? & What Kind of Insect Repellant to Use On Your Kids

DrKilbane — Fri, 25 Jun 2010 19:51:00 GMT

IS YOUR YOUNG CHILD CREATIVE WITH THE TRUTH?

Q: My 3 year old lies to me. She will openly say she didn’t do something when I know she did. Does she know she is lying and when and how should I address this?

Lying is a common theme for many kids at some point in their early years. Depending upon your child’s stage of development; they may or may not know they are lying. It’s important to ferret out their level of understanding and meet them halfway. A good friend of mine who has 2 daughters and has been a nurse for 22 years handled her daughter’s blatant fibs in the following way.

She related the words lying and trust together. When one person lies to another, that person can no longer trust what the other one says. She used a concrete safety example to make her point. She detailed the steps required for a mother and daughter to cross the street. Mom looks both ways, tells her daughter there are no cars coming and it is safe to cross. If mom was lying and there were actually cars coming down the street, the mother daughter duo would be in big trouble. Kids are able to trust parents because parents tell the truth (at least most of the time, right?!!). In my friend’s case, her daughter got it right away and the lying stopped immediately.

Be creative, honest, and use examples. Hopefully your child will find a way to actually wash their hands instead presenting a pair of grimy mitts and letting you know without a shadow of a doubt that yes, those hands were washed.

Good luck and let us know what you decide to do!

WHAT KIND OF INSECT REPELLANT TO USE ON MY KIDS?

The recommendation of the American Academy of Pediatrics is as follows:

DEET (N,N-diethyl-m-toluamide or N,N-diethly-3-methyl-benzamide)

DEET containing products are the most effective mosquito repellents available.

Protects against other insects and ticks

Concentration in products ranges from less than 10% to over 30%.

The percentage of DEET relates to how long is lasts on the skin.

Its efficacy plateaus at a concentration of 30%.

10% is effective for two hours

24% is effective for 5 hours

Select the lowest concentration effective for the amount of time spent outdoors.

Should not be applied more than once a day

It is not water-soluble and cannot be washed off.

Repeated application may increase the potential toxic effects.

Can be used down to 2 months of age

A natural recommendation by the CDC (Centers for Disease Control):

Oil of Lemon Eucalyptus (PMD para-Menthane-3,8-diol)

Plant- based repellent

Registered with the EPA

Found to provide protection similar to products with low concentrations of DEET

Should not be used in kids under 3

Repel is available at REI http://www.rei.com/product/703338

General rules for applying insect repellant:

Apply sparingly on exposed areas of skin

Do no apply on the hands

Avoid the area around the mouth and eyes

Do not use on cuts, wounds, or irritated skin

Wash treated skin and clothing with soap and water after returning indoors

Avoid spraying indoors and around food

The citronella plant (related to lemon grass) has long had a reputation in folk medicine as a bug repellent. If you want to keep the bugs away as naturally as possible, get some oil of lemon eucalyptus and a few citronella candles, and watch the mosquitoes run for cover!

Answering Mom's Question About Whole Milk and Allergies

DrKilbane — Mon, 01 Mar 2010 21:21:00 GMT

Mom Question:

My daughter is 3 years old and small so my pediatrician has recommended keeping her on whole milk. She drinks 5 to 6 cups per day and I think it is affecting her allergies. How much is too much milk?

Dr Kilbane:

Kids need about 16 to 24 ounces of milk per day. The American Academy of Pediatrics recommends whole milk until age 2, then skim or 1%. In the case of your daughter, it’s important to remember milk can be very filling. If I am worried about the weight gain of a young child, I advise parents to keep milk intake less than 24 ounces but at least 16 ounces per day.

The nutrients kids need from milk are calcium, vitamin D, and fat. The fat in milk is ok, but there are plenty of other foods that contain the good healthy omega-3 fats such as fish, avocado, walnuts, almonds, olive oil, and flax seed. Non-dairy foods high in calcium are: green leafy vegetables, broccoli, sesame seeds, celery, almonds, and oranges. Vitamin D is a little more challenging because the only foods which naturally contain it are cold water fish, shrimp, eggs, and foods fortified with vitamin D like milk, soy milk, cereals, and juices (and of course we also obtain vitamin D through sun exposure). There is nothing magical about milk it simply facilitates getting these nutrients into kids who won’t eat some of the foods I have listed

If you suspect your daughter is allergic to milk, take her off all dairy for 2 weeks (milk, cheese, cottage cheese, ice cream, pizza, etc.). If her runny nose, nasal congestion, and eczema clear up, then I would keep her off dairy for 3 to 6 months. When re-introducing it, monitor her symptoms, if they return, stay off the milk for another 6 months. Most kids outgrow their milk allergy by the time they are 5 or 6 but it can often be sooner.

Vitamin D

There is a lot of research currently extolling the virtues of vitamin D and recently the American Academy of Pediatrics came out with a new Recommended Daily Allowance (RDA) for kids. All infants, children, and adolescents need 400 international units per day. Polyvisol and Trivisol are liquid vitamins for babies which contain exactly that amount. They can be purchased from most pharmacies and are easy for young children to take. All kids (and most adults) should be on some type of a vitamin D supplement. I recently had my own vitamin D level checked and found it to be well below normal!

Integrative Medicine For Children

DrKilbane — Tue, 29 Dec 2009 02:34:00 GMT

Imagine if your pediatrician could combine the best of traditional and alternative medicine. She could talk to you about penicillin and echinacea, acupuncture and ear tubes, Ritalin and fish oil. Many pediatricians are making a shift towards integrative medicine, using safe and effective complementary therapies along with traditional allopathic medicine to facilitate the body’s innate healing response. The focus of integrative medicine is on health, wellness and prevention, not just disease management. It is a holistic and proactive way of healing of the whole child and concentrates on empowering patients and their families. All factors that influence health, wellness and disease are taken into consideration - mind, spirit, community and body. Effective interventions that are natural and less invasive are used whenever possible. Here are some integrative tips to keep your child healthy this winter:

Eat, Sleep, Play – Kids should eat plenty of fruits and vegetables to bump up the body’s natural immune protecting mechanisms. Adequate sleep keeps the body balanced and functioning properly. Kids should get at least 8-10 hours of sleep per night depending upon their age. Physical activity increases circulation, enhance the immune system and elevate the mood.

Vitamin D3 for Immunity - At this time of year, it is nearly impossible to get adequate amounts of vitamin D from the sun. Vitamin D plays a crucial role in the immune system. A dose of 400-800 IU’s for kids (depending on their age) can be extremely helpful is fending off illness.

Take a Probiotic Daily - Our guts contain “good” and “bad” bacteria. This bacteria contributes to our overall health by enhancing our immune system, aiding in digestion and preventing and/or decreasing the duration of diarrhea.

Try a Natural Cough Syrup -The American Academy of Pediatrics has warned against giving over the counter cough medicines to kids under the age of 6 years. Natural cough syrups have extremely low potential for harmful side effects and you can make them yourself. In a recent study, 1 teaspoon of honey at bedtime was found to be more helpful than dextromethorphan (the ingredient in delsym) for reducing cough. Honey is very safe, but cannot be given to kids under 1 year of age due to the risk of botulism. Thyme can be put in chicken noodle soup or made into a tea to relieve cough and nasal congestion. To make the tea, add ½ to 1 teaspoon of dried herb to a cup of hot water and steep for 3 to 4 minutes. Add some honey for taste if needed. This should not be given to kids under the age of 1 year.

Watch Ear Infections- Often ear infections will go away on their own if we give the body a little time to fight off the infection. So in most cases of ear pain, it is safe to utilize the “watchful waiting” prior to visiting the pediatrician. Ibuprofen (Motrin) is more effective for pain relief than acetaminophen (Tylenol) due to the anti-inflammatory component in Motrin. Ibuprofen can be given every 6 hours to kids over the age of 6 months and Tylenol can be given every 4 hours as needed for kids of all ages. Prescription ear drops contain benzocaine, a topical anesthetic that numbs the skin, and antipyrine, a pain reliever. A hot water bottle or heating pad (on low heat) placed next to the ear, relaxation/distraction techniques and massage can also help reduce pain. If the pain continues to get worse over the next few days and a temperature of 1010 F or above develops, a visit to the pediatrician’s office would then be the prudent course of action.

Ginger for the Tummy –Ginger is good for nausea, stomach upset, abdominal pain and aids digestion. Grate fresh ginger and place about 1-2 tsps into 2 cups of boiling water. Simmer for 20 minutes then drain. Add 1 tsp of honey. Place in refrigerator. Give 1 tsp as needed.

Echinacea for Sniffles –The herb Echinacea may help decrease the recurrence of colds and reduce secondary infections. But always remember if a cold lasts longer than 10 days, it’s time to see your doctor to make sure nothing else going on.

Dr. Sheila Kilbane, MD, is a pediatrician who is completing a 2 year Fellowship in Integrative Medicine through the University of Arizona. Her practice, Touchstone Health Associates in Cornelius, is the first clinic in the Charlotte area with four board-certified physicians who are all classically trained as well as trained in integrative medicine. Dr. Kilbane can be reached at 704-655-6300 or www.touchstonecare.com.